On a sweltering May afternoon, Lalit Kohli stood in a queue outside the gate of an oxygen refilling plant in the industrial area of Mayapuri, West Delhi, lugging a 47-litre empty cylinder with him. He looked exhausted. He had just driven 110 km from Shamli, Uttar Pradesh.

Nearly a fortnight ago, his uncle, Prem Chand Kohli, 46, had started feeling breathless. A resident of Pitampura in North West Delhi, he was taken by his family to the neighbouring Bhagwan Mahavir Hospital, but there were no vacant beds. The private hospital gave him oxygen in their emergency ward, but urged the family to take him elsewhere.

“They said treatment was not possible and that his condition was critical,” recalled Lalit Kohli, 29, who also lives in Pitampura and works as an IT professional in the city.

The next two days were spent looking for a hospital bed in Delhi. “The helplines were not working,” said Lalit Kohli. “I called the SDM [sub-divisional magistrate] of my area, he said there is no bed available in Delhi.”

The family then called up their relatives in Shamli district of Uttar Pradesh and found that a private hospital there was admitting Covid-19 patients. Lalit Kohli drove his uncle 110 kms – his breathing laboured, despite oxygen being administered to him through a small, portable oxygen cylinder all through the two-hour drive.

“It would not have been possible [to drive him] without a portable cylinder,” he said.

For a week after he was admitted to the Ganga Amrit Super Specialty Hospital in Shamli, Kohli’s uncle was recovering well. But on May 5, the hospital ran out of medical oxygen. The hospital authorities told families to either arrange for oxygen cylinders or shift their patients to other facilities, Lalit Kohli said.

He first tried to arrange for cylinders in Shamli but he did not know who to contact there. “All my connections in Shamli were distant, I tried through one friend but he was not able to arrange for it,” he said.

Since then, Kohli has been driving up and down between Shamli and Delhi to fill up oxygen cylinders for his uncle. He has made at least four trips since May 5 to fill up two cylinders of 40 kgs each. One cylinder lasts his uncle for barely a day.

“I do not have any other option,” said Lalit Kohli. It was an emergency, he said, and they had to stay vigilant.

An exhausted Lalit Kohli outside the refilling plant at Mayapuri. (Credit: Vijayta Lalwani)

An arduous task

In mid-April, Sahil Kansal, an income tax consultant in Delhi, started to volunteer with the Covid Citizen Action Group, a pan-India network of volunteers who assist patients looking for beds, medicines and oxygen.

On April 25, while helping others with their requests for beds, he received a call from his friend Bhaskar Mishra, 26.

Mishra’s father, Satish Mishra, 56, who was infected with Covid-19, was experiencing breathing trouble. “We took him to Rajiv Gandhi Super Specialty Hospital in a cab but the doctor refused to touch him and said there were no beds,” said Kansal. The family visited several hospitals but found no vacant beds.

That day, after being unable to procure an oxygen cylinder, Kansal procured an empty cylinder meant for argon, another inflammable gas, from a cylinder vendor in Mayapuri. “We thought we would buy it as a back up,” he said. “But some relatives told us to be careful and make sure it was cleaned professionally.”

The refillers were too busy to clean the argon cylinder and there were no empty oxygen cylinders in Delhi, Kansal recalled. “People were sourcing them from Manesar and Sonipat [in Haryana],” he said. “Those who were selling them had priced them between Rs 40,000 to Rs 50,000.” The price of an empty cylinder before the second wave of the pandemic struck was less than Rs 25,000.

Fortunately, by night, Kansal was able to secure an empty oxygen cylinder from a relative, but by then Satish Mishra’s oxygen saturation had dipped to 50. He was admitted to the casualty ward at Sir Ganga Ram Hospital, a private facility in Delhi. Two days ago, 20 patients had died in the hospital. An administrator had attributed their death to an oxygen shortage, although other authorities denied this.

For days, hospitals in Delhi had been sending out SOS messages, flagging the depleting levels of oxygen in their tanks. Some had even approached the Delhi High Court with urgent petitions for oxygen. Others had seen their patients die as the oxygen ran out.

To be abundantly cautious, Kansal and Bhaskar Mishra set out to Mayapuri to refill the cylinder in case the hospital ran out of oxygen. They arrived in the evening to see scenes of chaos. Hundreds of people had gathered there and had lined up before them.

“The police came and hit everyone with lathis,” Kansal recalled. “By the time it was our turn, the plant had run out of oxygen.”

Not willing to give up, Kansal and his friend drove to Turkman Gate in Old Delhi, where a charitable facility led by social commentator Tehseen Poonawalla was arranging for oxygen refills.

They kept the cylinder in the parking lot of the hospital, just in case the facility ran out of oxygen, he said. But eventually they did not need it. Satish Mishra died on May 7 at 10 am. “The hospital told us he was recovering from Covid but he got a heart attack,” Kansal said.

Kansal passed on the cylinder to a relative who was under home isolation.

At the cylinder refilling plant at Mayapuri. (Credit: Vijayta Lalwani)

Finding a refill

Vinayak Oxygen is a wide, rusty refilling plant, ring-fenced by a corrugated iron gate. The road leading up to it was barricaded on May 7 and manned heavily by police officials. Some people lugged around their cylinders while others laid them on the ground and rolled them with their feet towards the filling plant.

Inside, its employees stood on a raised platform gathering empty cylinders from a small crowd that was allowed inside.

Outside, police personnel went around demanding those who had come for refills to display their documents: a Covid-19 test result, a doctor’s prescription and an Aadhaar card.

On May 5, ostensibly to introduce transparency in the burgeoning oxygen economy, the Delhi government had made these documents mandatory for those seeking cylinders and refills. But as critics pointed out, with testing labs and hospitals overwhelmed, many patients needing oxygen support had neither been able to get Covid-19 tests nor hospital beds. Oxygen cylinders were their sole lifeline. The order would deprive them of even this.

Many people outside the refill plant in Mayapuri had not heard of the order. Sandeep Kumar was one of them. “They have told us just now that we have to get our documents,” said 33-year old Kumar exasperatedly. He was not carrying any of the documents with him.

A resident of Dwarka in South West Delhi, he had been waiting at the plant since the morning for nearly three hours. He needed to refill an oxygen cylinder for his 63-year-old father, who had tested positive for Covid-19 on April 20 and had spent two weeks recovering at home before his oxygen levels had abruptly and precipitously dipped.

Like many others, Kumar had tried his best but failed to find a hospital bed for his father. He then did what thousands of other families in Delhi have done in the past few weeks: he looked for an oxygen cylinder. To his luck, a relative who had recovered had an empty cylinder lying at home.

On May 6, Kumar drove nearly 10 km to Mayapuri with the empty cylinder and stood in a snakelike queue for five hours before he gave up and returned home. The plant had run out of oxygen even before his turn arrived, he said.

The next day, he returned to the oxygen refilling plant early in the morning. The police officials told him his token number would be called out in 30 minutes. He waited. But as he inched closer to the gate, he was told he needed to produce the documents.

He then called his relatives and asked them to send him a soft copy of the documents. For many others, however, this was another dead end in their search of oxygen in Delhi.